Co-author: Pippa Scott
Safely managed sanitation is a focus of the Sustainable Development Goals (SDGs). It is central to stunting reduction and early childhood survival, both identified by the World Bank’s Human Capital Index as critical for humans to develop their full potential. It is widely known that 4.5 billion people lacked access to safely managed sanitation in 2015, according to the Joint Monitoring Programme. Less well understood is that hundreds of millions more people in densely populated rural areas are exposed to significant health risk due to unsafely managed sanitation.
In contrast to urban areas, fecal sludge management (FSM) is not yet recognized as a priority for the rural sanitation sector – it is assumed to be less of an issue because rural areas are more sparsely populated. However, some densely populated areas fall under rural administrations, notably in deltas and on the periphery of rapidly growing rural areas. In these areas there is also a need to safely manage fecal waste. Many sanitation systems that, for lack of scrutiny, are assumed to be improved and safe, but due to lack of scrutiny they fail to safely manage fecal sludge.
Our new report - supported by the Global Water Security and Sanitation Program (GWSP) - and six case studies identified specific causes of health risks in locations in Bangladesh, Bolivia, Egypt, India, and Vietnam. They include compromised construction of on-site sanitation solutions, incorrect technology choices, poorly developed FSM markets, predominantly manual emptying practices and indiscriminate dumping of sludge in the immediate environment. They found that environmental regulations and building codes do not address FSM effectively, and enforcement is often weak. Rural administrations typically lack the mandate and institutional capacity to provide and manage FSM services.
Fecal sludge has been around since the dawn of humankind, and farmers have long recognized its value. So, it is not surprising that FSM services have emerged organically in many places around the globe. Six of such service models were studied, focusing on those that have emerged without external assistance demonstrate financial self-sufficiency. They found that these models provided only marginal incomes while posing significant health risks, and in some cases were socially stigmatizing to the workers.
Importantly, in all of these cases studied the service provided failed to ensure that fecal sludge is safely managed and does not pose a health risk to customers or workers. The services tended to operate informally, under the regulatory radar; it is likely that stronger regulations would make them unviable. The demand for such services is driven by convenience and not by safety or environmental concerns. Nonetheless, the cases highlighted that FSM entrepreneurship does occur, and there is market potential for FSM services. Under the right circumstances and with the necessary support, there is potential for entrepreneurship to scale up.
The case studies pointed to where market failures occur along the value chain – on transportation, safe treatment and re-use. These problems are particularly pronounced with infrequent or dispersed users. In rural areas, longer distances and lower population densities increase the per capita costs, often making these services expensive. Solutions include removing the need for transportation through in situ treatment; reducing the frequency of emptying through better-quality construction of sanitation technologies; and optimizing costs through scheduled emptying in well-defined areas.
Safely managing sanitation systems throughout their operational lifetime is vital in meeting the SDGs and contributing to the formation of human capital. Programs and policies should integrate safely managed sanitation by design. Current approaches to rural sanitation that focus on behavior change do not necessarily consider safe management of fecal sludge. Predominantly using emotional drivers, they encourage a focus on improving the super structure of a latrine and neglect the importance of a well-constructed sub-structure for safe management of fecal sludge.
These approaches need to be broadened to address health and environmental outcomes at each stage of the sanitation service chain— promoting more informed choices of sanitation technologies, supervising construction, and addressing the wider institutional issues of safely managing sanitation systems. Behavior change communications strategies need to refocus on the risks of unsafely managed sanitation and create demand for safe sanitation services.
The sanitation service chain spans both private and public goods, and market mechanisms are not always adequate to mitigate the safety risks. Public funding—whether through subsidy or market concession—will be needed to cover the affordability gap and address safely managed sanitation, requiring a clear and long-term commitment and support from government. The case is similar to that for networked sanitation: without public support, improving the safety of existing FSM services is likely to decrease profit margins and potentially render businesses unviable.
Projects or programs to scale private sector approaches to safely managing fecal sludge in rural areas need to be embedded in a holistic approach tailored to attaining the SDGs, with supportive and well-enforced policy and regulatory frameworks.
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